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June 17, 2011 -- The death rate from cancer is still dropping in the United States, continuing a trend that began almost two decades ago, according to the American Cancer Society (ACS).

Close to 900,000 Americans who would have been expected to die of cancer have not, with death rates down 22% for men and almost 14% for women from 1990 and 2007, ACS officials say.

60,000 Deaths Could Have Been Prevented

Each year, the ACS estimates new cancer cases and deaths from the disease in the current year and reports the latest data on cancer incidence and mortality.

Declines in smoking and better cancer screening and treatments have all contributed to the improvement in mortality, but the report highlights the fact that cancer deaths among the least educated Americans remain more than double that of those who are more educated and affluent.

Education level was used as a marker for socioeconomic status. The researchers concluded that:

Closing the education-socioeconomic gap would have prevented about 60,000 premature cancer deaths in 2007 alone in people ages 25-64.

In 2007, the last year for which mortality figures are available, the cancer death rate among the least educated Americans was 2.6 times higher than the death rate among the most educated.

The death rate from lung cancer was five times higher among the least educated Americans than the most educated.

ACS Vice President of Surveillance Research Ahmedin Jemal, PhD, tells WebMD that higher smoking and obesity rates among lower income Americans combined with less access to medical services largely explains the disparity.

One in five American adults (20%) now smokes, but the rate is half that for college graduates and more than twice as high for people without high school diplomas.

And while 70% of insured women get regular mammograms, only about 35% of uninsured women get them, Jemal says.

“We found that almost 37% of cancer deaths could have been avoided in 2007 alone if everyone experienced the same death rate as Americans with higher education status,” he says.

572,000 Cancer Deaths Expected in 2011

Close to 1.6 million new cancers will be diagnosed in 2011, and close to 572,000 Americans will die of the disease, the ACS estimates.

Among the other report highlights:

Overall cancer incidence rates were stable in men after declining by almost 2% a year between 2001 and 2005.

Among women, cancer incidence has been declining by about 0.6% a year since 1998.

Breast, lung, and colorectal cancer accounted for about half of all malignancies in women, while about half of malignancies in men were prostate, lung, and colorectal cancers. Breast and prostate cancers accounted for close to a third of all cancers in men and women, respectively.

The lifetime risk for having an invasive cancer remained higher for men (44%) than for women (38%).

About 1,500 Americans die each day from cancer.

Lung Cancer Still Leading Killer

Lung cancer remains the leading cancer killer among both men and women, with close to 157,000 deaths -- or 27% of all cancer deaths -- expected in 2011.

Since 1987, more women have died each year from lung cancer than from breast cancer, but lung cancer deaths have finally began to decline in women more than a decade after the death rate began to fall in men.

This is because women started smoking in large numbers decades after men, and also began quitting the habit decades later.

Breast Cancer Continues to Decline

An estimated 231,000 new diagnosis of invasive breast cancer and 40,000 breast cancer deaths are expected among women this year.

Breast cancer death rates have declined steadily since 1990, with the largest decreases seen in women under 50.

Incidence has also declined since 2000, with a dramatic 7% decline in the early part of the decade attributed to reductions in the use of hormone replacement therapy around the time of menopause.

Breast cancer specialist Leslie Montgomery, MD, tells WebMD death rates from breast cancer should continue to decline as more targeted treatments become available and researchers learn more about which patients will benefit from which treatments.

Montgomery is chief of the division of breast surgery and the director of breast service at Montefiore-Einstein Center for Cancer Care in the Bronx.

“The goal is to be able to know ahead of time which patients will benefit from chemotherapy and which ones don’t need it,” she says. “The majority of ladies with breast cancer probably don’t need chemotherapy, but we don’t really know who they are.”

Montgomery spent 11 years at Memorial Sloan-Kettering Cancer Center in Manhattan’s Upper East Side before moving to Montefiore, which serves a largely economically disadvantaged population.

She says she has seen firsthand the challenges that patients without economic or educational resources face.

“I’ve had patients tell me that breast cancer is just not their biggest problem,” she says. “Many of these women have no support systems and no wiggle room to be sick.”